title: Implementation of molecular intra-operative assessment of sentinel lymph node in breast cancer.
abstract: BACKGROUND
  Sentinel lymph node (SLN) biopsy is used as a staging procedure in early breast cancer, however, histology based intra-operative assessment of the SLN status has a low sensitivity. The one-step nucleic acid amplification (OSNA) method was developed to detect metastases by amplification of cytokeratin (CK) 19 mRNA. Experience with OSNA during a French multi-centric prospective study, as well as intra-operative clinical routine use, is reported.
  
  
  METHODS
  For the clinical study 80 SLNs from 46 patients were assessed. During routine use, the central slice of the SLN from 197 patients was investigated by permanent histology and the remainder was assessed by OSNA.
  
  
  RESULTS
  During the clinical study, OSNA detected 15/17 metastases, including all the macrometastases, reaching a 96.3% concordance rate, 88.2% sensitivity and 98.4% specificity. During routine use, both OSNA and histology detected 25 patients with metastasis.
  
  
  CONCLUSIONS
  OSNA is an accurate tool for intra-operative assessment of SLN status and could reduce the need for second surgery.
authors.affiliation: Department of Pathology, Service d'Anatomie Pathologique, S Etienne University Hospital, St Etienne, France. abir.khaddage@chu-st-etienne.fr
authors.forename: Abir
authors.initials: A
authors.lastname: Khaddage
authors.forename: Sid-Ali
authors.initials: SA
authors.lastname: Berremila
authors.forename: Fabien
authors.initials: F
authors.lastname: Forest
authors.forename: Alix
authors.initials: A
authors.lastname: Clemenson
authors.forename: Catherine
authors.initials: C
authors.lastname: Bouteille
authors.forename: Pierre
authors.initials: P
authors.lastname: Seffert
authors.forename: Michel
authors.initials: M
authors.lastname: Peoc'h
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D053539:Keratin-19 / Q000235:genetics; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D053539:Keratin-19; D012333:RNA, Messenger